Chinese Medicine Perspectives On Myocardial Ischaemia

Chinese medicine (CM) has treated cardiovascular disease (CVD) for hundreds of years, albeit under the auspices of very different clinical descriptors. CM is based on very different metaphysics to that of biomedicine, viewing the body and health in a vastly different manner, and its medical system has developed around this unique understanding. One could describe CM as an energetic model of the human, since CM views that body and indeed the world as being based on 'qi', a fundamental substance akin to 'energy'. It is necessary to understand the underpinning philosophies and theories that guide CM in order to appreciate how the cardiovascular system is understood and how it is treated with major modalities such as Chinese herbal medicine and acupuncture. CM has its own unique diagnostic techniques that are used to detect pathology in the body. A feature of diagnosis is the recognition of underlying patterns of disharmony (or CM syndromes) for diseases or disorders or symptoms. Treatment, typically with Chinese herbal medicine or acupuncture, is aimed at not only the disease but its underlying pattern of disharmony.In CM, the Heart has a much broader role than that described in western medicine. The Heart is believed to be the 'king of organs', an aphorism alluding to its key role in regulating emotions, and it is believed to be the seat of consciousness. Other organ systems within the body, including the 'Liver', 'Spleen' Lung' and 'Kidney' may be considered as forming part of the cardiovascular system from the CM perspective, though the understanding of these organ systems is vastly different to that in biomedicine. There are several CM syndromes of myocardial infarction which are typically treated with different Chinese herbal medicinal formulae, combinations of herbs judiciously chosen to address the underlying pathogenesis of that syndrome.This chapter presents an overview of CM and describes the components of the cardiovascular system and how CVD is conceptualised. It then describes how myocardial ischaemia is understood in CM including the various patterns of disharmony that are recognised and how these are treated with Chinese herbal medicine and acupuncture. Much scientific research has been conducted into the efficacy of Chinese herbal medicine treatment of myocardial ischaemia, and there are some promising findings, though also methodological shortcomings. Some examples are given of more recent research in this field.